The Implication of Socioeconomic Profile on Prognosis and Management Programs in Heart Failure Patients

ABSTRACT

Little is known about the obstacles to patients’ compliance to Heart Failure (HF) treatment. Heart Failure management programs seem to be a strategy to overcome these problems.

To evaluate in HF outpatients the role that socioeconomic characteristics and knowledge about the disease play in their compliance to treatment and long term mortality

We conducted a prospective study of consecutive HF outpatients attending our HF Clinic. Structured questionnaires directed to the patient or care giver were used. Patients´ socio-economic characteristics and understanding of the disease, as well as, predictors of long term mortality were accessed.

We included 59 consecutive NYHA II-III HF patients, age 70.5±11.9 years. Sixty three percent were male and 59.3% had left ventricular systolic dysfunction. Most patients had multiple comorbidities, were polymedicated, lived with their family and belonged to middle-low or low Graffar socioeconomic class. Eighty five percent were retired, median monthly income was 350, 41.5% had primary education and 22.6% were illiterate. More than half did not know they had HF, what HF was nor its main symptoms/ signs. Four year mortality was 23.6 %. Not knowing “what HF is” was the unique predictor of long-term mortality (p= 0.035; OR 0.097; CI: 0.011-0.846).

In our study Heart Failure patients were elderly, retired, and frequently dependent. Literacy was predominantly low. The need of polypharmacy, poor income and poor understanding of the disease were the rule. The later was even a predictor of long term mortality. Heart Failure management programs must be tailored to the needs of their users, taking into account their social environment.

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